Legion of Associated Airborne R.S.A.
 
PO Box 12356
Benoryn
1504
Gauteng
laarsa@acenet.co.za
083 647 0571
082 496 1089

  A PPLICATION FOR MEMBERSHIP
   (To be completed in dupicate)

Full name(s) :
    __________________________________________________________________________  
Surname :
  __________________________________________________________________________  
Name known by :
  __________________________________________________________________________  
Wife's name
  __________________________________________________________________________  
Residential address :
  __________________________________________________________________________  
  __________________________________________________________________________  
  __________________________________________________________________________  
  ______________________________________________________   Code : _____________  
Postal address :
  __________________________________________________________________________  
  __________________________________________________________________________  
  __________________________________________________________________________  
  __________________________________________________________________________  
  ______________________________________________________   Code : _____________  
Phone numbers :
  Home (_______) ____________________________  
  Work (_______) ____________________________  
  Cell (_______) ____________________________  
E-mail address :
  __________________________________________________________________________  
Date of birth :
  ______________________________  
Company and profession :
  ______________________________
Profession :
__________________________  
Military service record
   
   
Regiment/Unit qualified :
  ______________________________
Date :
__________________________  
Regiments served under :
  __________________________________________________________________________  
Proof of qualification (Log book/ Jump cert./etc) :
______________________________________________________  
(attach copy)   
       
Introduced by :
  ______________________________
Approved by :
__________________________  
Verified by :
  ______________________________
Approved by :
__________________________  
Date approved :
  ______________________________
Membership no :
__________________________  
Declaration: APPLICANT HEREBY ACCEPTS MEMBERSHIP IF SUCCESSFULLY APPROVED, AND AGREES TO
ABIDE BY THE CONSTITUTION OF THE LEGION
Applicant's signature :
  ______________________________
Date :
__________________________  
Membership fee :
  R   40-00
Receipt no. :
__________________________  
Subscription fee :
  R   60-00 Annually      
Stores :
  R 100-00      
TOTAL :
  R 200-00      
Signature :
 
Pay master
________________________________________________________________